Psoriasis is a T-cell mediated skin disease affecting 2-3 % of the world’s population. Methotrexate is known to be effective in the treatment of severe psoriasis. Like other currently used systemical treatments for psoriasis. Methotrexate has a significant potential for toxicity. It can cause bone-marrow toxicity, hepatic fibrosis, stomatitis, gastrointestinal intolerance, fever, alopecia and it is teratogenic. The anti-psoriatic drug, Fumaderm® or Fumarate '120', further referred to as ‘fumarate therapy’ or ‘fumarates’ has proven to be effective in psoriasis vulgaris. Systemic therapy with fumarates may be given to patients for prolonged periods because of its lack of serious side effects. Commonly reported side-effects of fumarates are flushing, gastrointestinal complaints, nausea, and tiredness. These side-effects usually occur during the induction of fumarate therapy.
This current study is designed to:
1. determine the efficacy of systemic fumarate and methotrexate therapy.
2. investigate the advantages of fumarate therapy in comparison with methotrexate therapy.
3. determine which of the two therapies induce a PASI reduction of ≥ 75 first.
4. investigate whether the change of PASI-score of patients treated with fumarates or methotrexate is maintained for a long period after cessation of the therapy.